May 14, 2015The following is in response to the information provided in the above noted complaint regarding this patient’s experience in my office:The patient referenced in this matter presented for eye health and vision examination 4/9/with concerns regarding poor distance visionThis was her first visit to our office.Refractive examination indicated a change in glasses prescription which significantly improved her distance visionShe was given the option of distance vision or multifocal correction, took her written Rx with her, and had a distance correction filled which helped clear her distance vision.During the eye health examination a small depigmented area was noted on the retina of the right eyeIt was explained to the patient that this could be a drusen which is a benign degenerative change to the retina or it could be indicative of future concerns as a precusrsor to macular degenerationThis was visible in the central area of the retina which does not require dilationOur office standard has always been to schedule dilation visits, when necessary, at a separate visit so as not to compromise vision measurements and to allow the patient to plan for the vision effects of the dropsThe patient was instructed to return in about one month to re-evaluate the retina for changesShe was scheduled and returned 5/11/to note the appearance of the central right retina, she was dilated at that time to also check peripheral retinaThe primary purpose of this visit was recheck the suspicious areaShe was scanned using an OCT (Optical coherence tomography), which affords an MRI like view of the retinaFortunately, this confirmed the drusen diagnosis (which can still potentially lead to macular degeneration) as opposed to an active macular degenerative changeThe patient was advised of such and told of the importance of routine yearly check-ups and to notify our office should she experience any vision changes.As in most offices, our practice routinely charges fees for patient visits and ancillary testingIn this case we typically present the patient with a charge slip indicating the office visit and the test procedure itself (much like a primary care physician suggesting a blood test or stress test and then scheduling an appointment to go over the results).I do not know where or when this patient was told there would be no charge for subsequent visitsI have discussed the matter with each of my three staff members (who share a combined experience of better than years here), and none recall this conversation with the patientAt check-out the patient was presented with a fee slip for her office visit and for the OCT scan which calmed our concerns regarding eye healthThe patient claimed, at that time, that she was told there would be no charge for this follvisitMy staff member came to me with this information and verified that she has no recall of patient being told there would be no feesI instructed my staff to tell the patient that we typically do charge for office visits here but if she feels that she was misinformed we’ll chalk it up to a miscommunicationI instructed front desk staff to waive our office fee ($70), and limit the patient charge to the test procedure ($90)Patient paid the fee and left.My next communication came via email at 12:(5/11/2015) telling me that the she would have “come back every year”However, because we charged her she considers this to be “a scam” and will report us to “ [redacted] ***”We tried to contact the patient via phone and left a message to discuss her concerns and to confirm with her that we had indeed waived the visit portion of the feeI received another email 4:am (5/13/2015) advising that there is “nothing to talk about”, “this is a scam”, and that she is reporting this scam to TV newsYour Revdex.com letter arrived later in the mail.In Synopsis, if during a routine examination a suspicious retinal defect is detected I feel obliged to have the patient return and look furtherI utilize the latest examination equipment to evaluate eye health and do routinely charge for additional test proceduresI typically charge patients for our office visits which go beyond the routine examinationMy office staff does not recall telling this patient she would be seen at no charge but did waive our office visit fee in view of the patient’s claimsI did not waive the test fee for the OCT which was necessary to evaluate this patient as it is certainly not part of a routine eye examinationThe patient refused to respond to our phone call to discuss her concerns.I trust the above offers a different light to this situationI had thought we had resolved this issue by waiving the office visit fee for this patientI cannot operate an up-to-date office on a no charge basis.Howard SBookbinder, O.D
May 14, 2015The following is in response to the information provided in the above noted complaint regarding this patient’s experience in my office:The patient referenced in this matter presented for eye health and vision examination 4/9/with concerns regarding poor distance visionThis was her first visit to our office.Refractive examination indicated a change in glasses prescription which significantly improved her distance visionShe was given the option of distance vision or multifocal correction, took her written Rx with her, and had a distance correction filled which helped clear her distance vision.During the eye health examination a small depigmented area was noted on the retina of the right eyeIt was explained to the patient that this could be a drusen which is a benign degenerative change to the retina or it could be indicative of future concerns as a precusrsor to macular degenerationThis was visible in the central area of the retina which does not require dilationOur office standard has always been to schedule dilation visits, when necessary, at a separate visit so as not to compromise vision measurements and to allow the patient to plan for the vision effects of the dropsThe patient was instructed to return in about one month to re-evaluate the retina for changesShe was scheduled and returned 5/11/to note the appearance of the central right retina, she was dilated at that time to also check peripheral retinaThe primary purpose of this visit was recheck the suspicious areaShe was scanned using an OCT (Optical coherence tomography), which affords an MRI like view of the retinaFortunately, this confirmed the drusen diagnosis (which can still potentially lead to macular degeneration) as opposed to an active macular degenerative changeThe patient was advised of such and told of the importance of routine yearly check-ups and to notify our office should she experience any vision changes.As in most offices, our practice routinely charges fees for patient visits and ancillary testingIn this case we typically present the patient with a charge slip indicating the office visit and the test procedure itself (much like a primary care physician suggesting a blood test or stress test and then scheduling an appointment to go over the results).I do not know where or when this patient was told there would be no charge for subsequent visitsI have discussed the matter with each of my three staff members (who share a combined experience of better than years here), and none recall this conversation with the patientAt check-out the patient was presented with a fee slip for her office visit and for the OCT scan which calmed our concerns regarding eye healthThe patient claimed, at that time, that she was told there would be no charge for this follvisitMy staff member came to me with this information and verified that she has no recall of patient being told there would be no feesI instructed my staff to tell the patient that we typically do charge for office visits here but if she feels that she was misinformed we’ll chalk it up to a miscommunicationI instructed front desk staff to waive our office fee ($70), and limit the patient charge to the test procedure ($90)Patient paid the fee and left.My next communication came via email at 12:(5/11/2015) telling me that the she would have “come back every year”However, because we charged her she considers this to be “a scam” and will report us to “ [redacted] ***”We tried to contact the patient via phone and left a message to discuss her concerns and to confirm with her that we had indeed waived the visit portion of the feeI received another email 4:am (5/13/2015) advising that there is “nothing to talk about”, “this is a scam”, and that she is reporting this scam to TV newsYour Revdex.com letter arrived later in the mail.In Synopsis, if during a routine examination a suspicious retinal defect is detected I feel obliged to have the patient return and look furtherI utilize the latest examination equipment to evaluate eye health and do routinely charge for additional test proceduresI typically charge patients for our office visits which go beyond the routine examinationMy office staff does not recall telling this patient she would be seen at no charge but did waive our office visit fee in view of the patient’s claimsI did not waive the test fee for the OCT which was necessary to evaluate this patient as it is certainly not part of a routine eye examinationThe patient refused to respond to our phone call to discuss her concerns.I trust the above offers a different light to this situationI had thought we had resolved this issue by waiving the office visit fee for this patientI cannot operate an up-to-date office on a no charge basis.Howard SBookbinder, O.D